I continue to work with young children with Autism/PDD using ABA (Applied Behavior Analysis).

Currently, I am working with a 3 year old boy, a 4 year old girl, and a 5 year old boy. Both the 3 year old boy and the 4 year old girl are receiving intensive (30-40 hours weekly), home based applied behavior analysis (ABA) including discrete trial teaching. The 5 year old boy is receiving approximately 10 hours weekly of home based discrete trial teaching in addition to center based special education.

I will only briefly describe applied behavior analysis. For those interested in a more thorough discussion, my links page can take you to sites with numerous ABA links. As Lovaas has suggested, it is likely that children with Autism/Pervasive Developmental Disorder have atypical neurological systems. The typical child’s neurological system is optimized for typical learning environments. Typically developing children are learning at all waking hours through their interactions with and observations of their environments. Children with atypical neurological systems are unfortunately a poor fit with typical learning environments. Unable to learn efficiently from typical environments, they are less able or unable to navigate environmental challenges and comprehend/predict the behavior of others in their environment. The world is likely a harrowing place for those who cannot comprehend/predict and many theorize that this may be an explanation for the social withdrawal seen in Autism as well as the clinging to repetitive routines.

Many professionals continue to question the intensity of ABA with young children. For those who have significant experience in the field, this seems odd and unfortunate. Though the published research on intensity is limited, it is quite suggestive that greater intensity (i.e., hours per week in 1:1 therapy) leads to greater global gains. Those of us who have had the experience of working in both preschools that provide roughly 5-7 hours per week of discrete trial teaching with little support of extension into the home environment and intensive preschools that provide 25 plus hours weekly of discrete trial teaching in addition to 10 or more home based hours weekly can attest to the staggering difference in progress that accompanies the difference in intensity. The likelihood of a young, preschool age child with Autism/PDD making the type of gains necessary to be included in regular education in elementary school is quite small when the intensity drops below 20 hours per week of therapy. Still, many preschool programs eager to be able say that they “do ABA” (probably due to rise in demand for an approach which has demonstrated results) continue to provide as little as 5 hours weekly of discrete trial teaching. Many of these programs openly endorse a multimodal approach with a “little ABA” intermixed with TEACCH and perhaps some sensory integration. ABA was never meant to be a “part time” treatment approach and is of limited, if any, use as such . A former teacher of the 3 year old boy whose home based program I supervise, upon learning that he was receiving 35 hours per week of discrete trial teaching said to the parent that 35 hours was much too much and that it was summer time so he should be out playing. Five months into intensive discrete trial teaching, this young boy uses several functional phrases (he only knew a couple of words previously), knows several body parts receptively and expressively, knows 12 colors receptively and expressively, knows all his shapes receptively and expressively, can identify more than 10 objects receptively and expressively, can identify pictures of several familiar people receptively and expressively, has basic yes/no concept, knows many 1 step directives, can answer about 6 social questions, and has learned to receptively and expressively identify his first 3-4 numbers and letters . I wonder what he might have learned had he been spending more time outside playing or had been receiving the typical treatment of a special education preschool that does a “little bit of ABA.”

The reason that young children with Autism/PDD require this level of intensity can be traced back to Lovaas’ theorizing. As discussed above, typically developing children are learning from their environments at all waking hours (12-14 hours daily). Using discrete trial teaching with a 1:1 setting, the environment is being structured to be a more optimal learning environment for children with atypical neurological systems. Clearly, in order for an atypically developing child to begin to compete with the learning opportunities of a typically developing child, this optimally structured environment is required for many hours daily.

In our next update, we will take a look at the progress of the 2 children receiving intensive, home based ABA. Specifically, we will look at their progress as assessed by a standardized measure, the Vineland Adaptive Behavior Scales . Please click on "Vineland Scores" on the menu buttons above to access Vineland scores. Please click on "ABA Updates" on the menu buttons above to access updates.